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Monday, May 30, 2011

Ticks are EVIL!

Chandler finished two months of antibiotic treatment for anaplasmosis today. Like lyme, anaplasmosis is a tick borne disease. This saga actually started about two years ago, when Chandler's routine snap test for heartworm and three tick diseases showed a positive for anaplasmosis.

But I like this tick. I chose it myself.

The next thing I discovered was that it is difficult to find a veterinarian well-versed with treating tick borne diseases. My regular vet sent me home with the message "he's not showing symptoms, so we don't need to worry about it at the moment." I wandered online just to find out what anaplasmosis was and what symptoms I should watch out for and discovered that maybe I SHOULD worry about it.

I found an excellent webpage titled Tick Disease in Dogs, that led me to the Tick List information page, where I could do more online exploration and also join a listserv where people went for support and suggestions when treating their dogs for tick borne diseases. Both of these are excellent resources that I have since recommended to other people. I learned a lot from the people on the listserv. It turns out that many vets do not realize that there is no such thing as a "faint positive" on an IDEXX Snap4Dx test. Instead it is simply a yes or no test that indicates whether the dog is producing antigens or antibodies to the organism being tested for. I also discovered that misdiagnosing and insufficient treatment were common problems people had when working with their vet to try and treat a tick borne disease. The first is understandable since so many tick diseases have vague symptoms that can be mistaken for something else. However, it seemed like many people came to the Tick List after their concerns were ignored or their dog had been treated with insufficient antibiotics.

In 2009, Chandler was treated with 250 mg of doxycycline twice a day for 30 days. This was actually 30 days less than recommended by the Tick List, but I didn't fuss too much as Chandler's appetite had been badly affected by the doxycycline. Looking back, I should have had an initial anaplasmosis titer done when he started treatment, but I was short on funds at the time and elected to check his titer 6 months later. Unfortunately, without the initial titer, I had no baseline to determine if his treatment had been successful. Instead I elected to keep monitering his titer for changes.

That was the way things stood until this March, when Chandler's latest titer had jumped from 1: 1280 to 1:5120. That's a twofold jump in magnitude. I had not seen any behavioral symptoms, but further testing showed a drop in neutrophils, the white blood cells that anaplasmosis affects. Either Chandler's original infection had rebounded, or another deer tick had gotten to him, despite my religious use of Frontline.

I elected to treat Chan again, this time with a more rigorous regimen of 250 mg doxycycline twice a day for the full 60 days. It turned out that he did have a subtle behavioral symptom of anaplasmosis. Soon after we started treatment Chandler suddenly stopped "dithering" when choosing a spot during his "bathroom breaks". Things went fairly well for the first week or so of treatment, and then Chander started to show finickiness when eating. First he didn't want to eat his kibble, then he rejected the canned pumpkin that I was adding to help keep him regular despite the antibiotic. I switched him to canned food, and baked the canned pumpkin into pumpkin bread, which he would eat.

Then on April 10th, we went out hiking with friends and Chandler strained his iliopsoas muscle. This resulted in 10 days of Deramaxx being added to the pills Chandler was taking, to help manage his pain. As this treatment went on, Chandler got fussier and fussier about food, until he was only eating things like cooked chicken, lamb, or venison with his pumpkin bread thrown in. Since Chan normally eats just about anything, I was worried enough to take him in for some more testing.

It turned out that Chandler's liver values had risen to practically stratospheric levels. This was dangerous, so we stopped the doxycycline, switched to 250 mg of ciprofloxactin two times per day, and started giving Denamarin once per day to support his liver. Unfortunately for me, Denamarin should be given on an empty stomach one hour before eating. Chandler got his liver support pill at 5 am when the cats got breakfast, then I'd try to nap for an hour before getting his breakfast and antibiotic. The hour after that the cats usually ran me over again. With my work schedule, I usually try to feed the cats and then get a few more hours of sleep. Chandler's morning pills have made this a rough month for me. I am very glad they are finished.

I hope we managed to wipe out the anaplasmosis this time around. In six months I'll have another titer done at Protatek, and see what it says. In the meantime, I'll fuss about flea and tick treatments and try to find tiny deer ticks on a fuzzy black dog. It is a worry that will probably never go away, but I'll hope for the best.

To be honest Rob, aside from the stratospheric liver values, what I've gone through with Chandler is minor compared to some of the stories I have heard or read from friends or on the Tick List about the treatment of tick borne diseases.

Chandler has never gotten to the point where he has any easily noticed symptoms. No limping, no neurological symptoms, no major changes in wellness or behavior. I've been lucky so far. It can be much worse.

Yes, I am hoping Chan will be truly well. But in the meantime, if I can help other people dealing with tick borne diseases in their dogs get the information they need, I'll count that as a win.